Vaginal birth after cesarean delivery.
By 2004, only 9.2% of women in the United States with prior cesareans underwent a term of labor (TOL), although nearly two thirds of these women are actually candidates for a TOL. In this article, the author notes that the principal risk associated with vaginal birth after cesarean delivery (VBAC)-TOL is uterine rupture, which can lead to perinatal death, fetal hypoxic brain injury, and hysterectomy. Risk factors for uterine rupture include number of prior cesareans, prior vaginal delivery, interdelivery interval, and uterine closure technique. The author concludes by noting that a pregnant woman with prior cesarean delivery is at risk for maternal and perinatal complications, whether undergoing TOL or choosing elective repeat operation. Complications of both procedures should be discussed and an attempt made to individualize the risk for uterine rupture and the likelihood of successful VBAC.
Landon
Mark B
MB
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, The Ohio State University College of Medicine, Means Hall, Room 509, 395 W. 12th Avenue, Columbus, OH 43210-1228, USA. landon.1@osu.edu
D017604:Cesarean Section, Repeat / Q000009:adverse effects; D003376:Counseling; D005260:Female; D006801:Humans; D007744:Obstetric Labor Complications / Q000209:etiology; D018579:Patient Selection; D011247:Pregnancy; D012307:Risk Factors; D014219:Trial of Labor; D014597:Uterine Rupture / Q000209:etiology; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects